Mediterranean diet: Heart-healthy eating plan

If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet incorporates the basics of healthy eating — plus a splash of flavorful olive oil and perhaps even a glass of red wine — among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.

Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet remain tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.

Benefits of the Mediterranean diet

Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. In fact, an analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of death from heart disease and cancer, as well as a reduced incidence of Parkinson's and Alzheimer's diseases.

The Dietary Guidelines for Americans recommends the Mediterranean diet as an eating plan that can help promote health and prevent disease. And the Mediterranean diet is one your whole family can follow for good health.

The diet also recognizes the importance of being physically active, and enjoying meals with family and friends.

Focus on fruits, vegetables, nuts and grains

The Mediterranean diet traditionally includes fruits, vegetables and grains. For example, residents of Greece average six or more servings a day of antioxidant-rich fruits and vegetables.

Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil — not eaten with butter or margarine, which contains saturated or trans fats.

Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat, but most of the fat is healthy. Because nuts are high in calories, they should not be eaten in large amounts — generally no more than a handful a day. For the best nutrition, avoid candied or honey-roasted and heavily salted nuts.

Choose healthier fats

The focus of the Mediterranean diet isn't on limiting total fat consumption, but rather on choosing healthier types of fat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.

The Mediterranean diet features olive oil as the primary source of fat. Olive oil is mainly monounsaturated fat — a type of fat that can help reduce low-density lipoprotein (LDL) cholesterol levels when used in place of saturated or trans fats. "Extra-virgin" and "virgin" olive oils (the least processed forms) also contain the highest levels of protective plant compounds that provide antioxidant effects.

What about wine?

The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, alcohol — in moderation — has been associated with a reduced risk of heart disease in some research studies.

The Mediterranean diet typically includes a moderate amount of wine, usually red wine. This means no more than 5 ounces (148 milliliters) of wine daily for women of all ages and men older than age 65 and no more than 10 ounces (296 milliliters) of wine daily for younger men. More than this may increase the risk of health problems, including increased risk of certain types of cancer.

If you're unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol.

Putting it all together

The Mediterranean diet is a delicious and healthy way to eat. Many people who switch to this style of eating say they'll never eat any other way. Here are some specific steps to get you started:

Eat your veggies and fruits — and switch to whole grains. Avariety of plant foods should make up the majority of your meals. They should be minimally processed — fresh and whole are best. Include veggies and fruits in every meal and eat them for snacks as well. Switch to whole-grain bread and cereal, and begin to eat more whole-grain rice and pasta products. Keep baby carrots, apples and bananas on hand for quick, satisfying snacks. Fruit salads are a wonderful way to eat a variety of healthy fruit.

Go nuts. Nuts and seeds are good sources of fiber, protein and healthy fats. Keep almonds, cashews, pistachios and walnuts on hand for a quick snack. Choose natural peanut butter, rather than the kind with hydrogenated fat added. Try blended sesame seeds (tahini) as a dip or spread for bread.

Pass on the butter. Try olive or canola oil as a healthy replacement for butter or margarine. Lightly drizzle it over vegetables. After cooking pasta, add a touch of olive oil, some garlic and green onions for flavoring. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter. Try tahini as a dip or spread for bread too.

Spice it up. Herbs and spices make food tasty and can stand in for salt and fat in recipes.

Rein in the red meat. Limit red meat to no more than a few times a month. Substitute fish and poultry for red meat. When choosing red meat, make sure it's lean and keep portions small (about the size of a deck of cards). Also avoid sausage, bacon and other high-fat, processed meats.